Acceptability of Oral Immunization Against Cholera and Typhod Fever among School Children in Lusaka

Abstract

Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis. There were 14.4 million individuals worldwide living with TB including half a million cases of Multidrug-resistant (MDR) TB in 2006. A most serious aspect of the problem has been the emergence of MDR-TB and extensively drug-resistant (XDR) TB. MDR-TB is defined as a strain of Mycobacterium tuberculosis that is resistant to at least Isoniazid and Rifampicin whether there is resistance to other drugs or not. XDR-TB is defined as resistance to at least rifampicin, isoniazid, a second line injectable drug (capreomycin, kanamycin or amikacin) and a fluoroquinolone.China, India and the Russian Federation are thought to carry the largest MDR-TB global caseload. World Health Organization (WHO) estimates that there were 66,700 MDR-TB cases in Africa in 2006. In 2005 approximately 50 cases were reported as having MDR-TB in Zambia. Treatment of MDR-TB requires prolonged and expensive chemotherapy. The main objective of this study was to determine the prevalence of and factors associated with MDR-TB among adults with TB at University Teaching Hospital (UTH) in Lusaka, Zambia. Specific objectives were to describe the demographic characteristic of patients presenting with MDR-TB, determine the proportion of MDR-TB cases among TB culture-positive patients, and to determine the association between HIV/AIDS, previous TB treatment and compliance on one hand and MDR-TB on the other.A cross-sectional study was conducted in UTH TB Laboratory in Lusaka among culture-positive TB patients. Facility TB records and databases for M tuberculosis isolates which were cultured and had drug-sensitivity testing performed against four first-line anti-TB drugs were studied retrospectively. All the records and databases available between 2003 and 2008 were reviewed. The results have been presented in graphical and tabular form. The proportion of MDR-TB among the TB culture-positive patients was 10.9%. The association between age and MDR-TB was not statistically significant. The observed proportions of females between positive and negative were statistically different. There was no significant association between employment status and MDR-TB. There was an association between HIV/AIDS and MDR-TB. There was an association between compliance and MDR-TB.We conclude that there is need for continuous monitoring of MDR-TB and XDR-TB.